Therapist Jason Rowley has an unusual clientele: the patrons of Regent Park Community Health Centre, in a rough, run-down Toronto neighborhood. Unusual only because “well-educated, relatively wealthy females are by far the most likely Canadians to be referred to mental health specialists,” reports The Walrus. “The implication is that they are thought to have the time and verbal acuity to engage in talk therapy.”

Rowley respectfully disagrees with the referential bias, which is why he’s intent on practicing cognitive-behavioral therapy in Regent Park. The brand of therapy focuses on identifying and then questioning assumptions that people hold about themselves (i.e., “I always screw up relationships”). From there, the work is figuring out how to “loosen their grip.”

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It’s an approach that Rowley thinks is particularly valuable for his clients. “These neighborhoods are like crab buckets,” he tells The Walrus. “As soon as you start climbing out, there are five situations, or five social determinants, pulling you back.” Instead of prescribing medication or plumbing childhood trauma, cognitive-behavioral therapy considers clients’ circumstances and is ultimately goal oriented—focusing on making everyday life more productive.